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<br />. CONDITIONS OF PERMIT AFFIDAVIT
<br />1\. NOTICE OF DEED RESTRICTIONS
<br />The undersigned understands that this perlit lay be subject to "deed restrictions" wbieb Jay be lOre restrictive than City
<br />regulations. Ibe undersigned assUles responsibility for COIpliance with any applicable deed restrictions.
<br />. ~1
<br />B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
<br />If the owner bas bired a contractor or contractors to undertake worl, tbey lay be required to be licensed in accordance witb
<br />state and local regulations. If the contractor is not licensed as required by law, both the OlDer and contractor JaY be
<br />cited for a lisdeteanor violation under state law. If the owner or intended, contractor are uncertain as to what licensing
<br />requireaents JaY apply for the intended work, they i1ie advised to contact the City of Zephyrbills Building DepartJent, (813)
<br />788-6611. .
<br />
<br />FurtberlOre, if the owner bas hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the
<br />"Contractor Sections" of this a~plication for which they will be responsible. If you, as the owner sign as the contractor,
<br />you are indicating that you, rather' than the contractor, are responsible for the worl. If the contractor wishes you to sign
<br />as contractor that Jay be an indication that he is not properly licensed and is not entitled to perlitting privileges in the
<br />City of Zephyrllil1s. ,
<br />
<br />C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
<br />
<br />D. CONSTRUCTION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
<br />I certify that I, the applicant, have been provided with a copy of "Florida's Construction Lien Law - HoIeoIner's Protection
<br />Guide" prepared by the Florida DepartJent of Agriculture and Consular Affairs. If the applicant is sOleone other tban the
<br />"owner", I certify that I have obtained a copy of the above described docUJeDt and prOlise in good faith to deliver it to the
<br />"owner" prior to COllBDcel8nt.
<br />
<br />E. CONTRACTOR'S/OWNER'S AFFIDAVIT
<br />I certify tbat all the inforlation in this application is accurate and that all IOrt will be done in cOlpliance with all
<br />applicable law. regulating construction, loning, and land developlent.
<br />
<br />Application is hereby Jade to obtain a perlit to do worl and installation as indicated. I certify that no IfOr1 or
<br />installation has COIIenced prior to issuance of a perlit and that all worl will be perfoIled to leet .tandards of all lal.
<br />regUlating construction, City codes, loning regulations, and land developieDt regulations in the jurisdiction. I also
<br />certify that I understand that the regulations of other goveIDIental agencies Jay apply to the intended IOr1, and that it is
<br />IY responSibility to identify what actions I lust tale to be in COIpliance. Such agencies include but are not liJIted to:
<br />t DepartJent of EnvirODJeDtal Regulation - Cypress Bayheads, Wetland Areas and EnviroDlentally Sensitive Lands,
<br />Water/Wastewater IreatJent .
<br />t Southlest Florida Water Hanagetent District - Wells, Cypress Baybeads, Wetland Areas, Altering Watercourses
<br />t ArlY Corps of Engineers - Seawalls, Docks, Havigable Waterways
<br />t DepartJent of Health , Rehabilitative Services, BnvirODlental Health Unit - Wells, Wastewater IreatJent, Septic lants
<br />t US BnviroDlental Protection Agency - Asbestos abatl!leDt
<br />I also certify that, if fIll laterial is to be used in Flood Zone "A" or "A,etc.", it is understood that a drainage plan
<br />addressing a "COIpeDsating volute" will be subtitted which is prepared by a professional engineer registered in the State of
<br />Florida prior to perlit issuance.
<br />
<br />A perlit issued shall be construed to be a license to proceed lith the lorl and not as authority to violate, cancel alter, or
<br />set aside any provisions of the technical codes, nor shall issuance of a perlit prevent the Building Official frOJ thereafter
<br />requiring a correction of errors in plans, construction, or violations of any code. Bvery peIlit issued shall beCOle invalid
<br />unless the worl authoriled by sueb perlit is cOll8nced within sil IODthS of issuance, or if IfOrl authoriled by the per.it is
<br />suspended or abandoned for a period of sil IOnths after the tile the worl is c_enced. One 90 day utension of tile, JaY be
<br />allowed for the perlit with fee charge of $15.00. fhe 81tension shall be requested in writing to the Building Official. An
<br />approved inspection lUSt be logged during each six lOoth period, or the project will be considered abandoned.
<br />WARNING TO OIIIBR: YOUR FAILURE TO RBCORD A NOrlCE OF aJIMBIICBIIm IlAY RESULr IIf YOUR PAYlIG lllCE FOR 1MPROVBIIBIIT8 TO YOUR
<br />PROPERTY. IF YOU IfIIBHO 10 OBIAIN FIHANCIHG, COHSULI WIIH YOUR LBNDER OR AN AnORlBY BBFORE RlCORDING YOUR NOIICH OF
<br />COMHEIfCEHBH'f. JOBS UIDIR $2,500 IN !JLJlB 00 HOI HIED 10 RECORD AND POSI A -HOIICE OF OIfHBHCBIIBfII".
<br />YfL '2 --f21 -'-1- oDt. - 0
<br />, ' ! r \
<br />/ ',- f.--~ \.'-.c<-.,
<br />SIGHAT RE: COIIlRAClOR
<br />
<br />
<br />STATI OF FLORIDAh
<br />cooHlr OF t::?AA" ...<J
<br />The foregOing instrument was acknowledged
<br />before me this O~ )t" 19 as by
<br />~ .-L.:L
<br />
<br />who is personally known to me or who has
<br />produced
<br />as identific~tli~WIi~ who did/did not
<br />f:....'~ R Y P II,
<br />take an oa~~t>:'''''''h'~O'~~' J /
<br />~~- L~<'_~
<br />(Signature f \ ("I
<br />'P /I.q!jl/~ JA . * 1- ..1 ~ Lifl /1 ge 0
<br />(Name. :r-yp~ "~.~1nt~~"~DW Stamped)
<br />NOTARY PUBY~P' ~ G.........'.} ~ \/'
<br />~. F f\. \\\'
<br />1//11/'111\\1\\1\
<br />
<br />STATB OF FLORIDA /J
<br />coony OF ~~
<br />The foregoing instrument was aCknowledged
<br />before me thisc9~ Ila-d1, 19~ by
<br />
<br />
<br />who is personally known to me or who bas
<br />produced
<br />as identificat~,~'\l~d"i".ho did/did not
<br />take an o~tb.;::,,"'" l>.f}....p~;~ J Jl
<br />. ~O . ....~~~
<br />(Signatu1;e) ~ / \ "....~,
<br />VI ff .AJo/+11 [-Jr. ''''''lYI1'DE L-
<br />(Nue Typed h~~.~ted !?.r....spu.ped)
<br />NOTARY PUBLr~ /(' ............. ';\ ,"'<~'
<br />//I/!.'",(IF !1" C .:',,<.,"
<br />
<br />
<br />Notary Public, 'Stiii:'-' d ,';urida
<br />DIANNA L. n.L,A....l
<br />My Comm. Exp. NOli. 11,1995
<br />Comm. No. CC 1-50:34
<br />
<br />Not,
<br />
<br />
<br />I du,-:da
<br />My Com!"".;. Exp. f'h'1o. '1"i~EIL99S
<br />Comm. {~O. CL; :J9184
<br />
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